Treatment Of Pterygium Research Articles

Preliminary observation on the treatment of primary pterygium with modified conjunctival transplantation and amniotic membrane transplantation combined with use of interferon eye drops

Objective: To observe the clinical effect of modified conjunctival transplantation and amniotic membrane transplantation combined with use of interferon (IFN) alpha-2b eye drops in the treatment of primary pterygium. Methods: This was a prospective case-control study. Patients with primary pterygium were treated from June 1, 2018 to December 31, 2018 in the Department of Ophthalmology, Beijing Tongren Hospital, and they were divided into two groups (the experimental group and the control group) by the method of randomized block design. Patients in the experimental group received modified conjunctival transplantation and amniotic membrane transplantation combined with use of IFN alpha-2b eye drops, while patients in the control group received pterygium resection combined with conjunctival autograft transplantation. The pterygium type and size were observed before operation, while visual acuity, intraocular pressure and anterior segment details were recorded either. The follow-up was done at 1 week, 2 weeks, 1 month, 3 months, 6 months and 12 months after operation. The visual acuity, corneal epithelial defect, and pterygium recurrence were observed. All data in this manuscript are enumeration data, the expected frequency of pterygium type distribution in the two groups was more than 5, and the chi square test was used, fisher's exact test was used to compare the other data between the two groups. Results: Seventy patients (77 eyes) with pterygium were in this study, including 30 males and 40 females, aged from 50-70 years old. There were 35 cases (38 eyes) in the experimental group and 35 cases (39 eyes) in the control group. 12 months after operation there were 54 cases (60 eyes) including 28 cases (30 eyes) in the experimental group and 26 cases (30 eyes) in the control group with complete data. The corneal epithelium defects of 1 eye in each group was repaired within 7-14 days after operation, and the rest eyes were completely repaired within 7 days after operation. There was no significant difference in the distribution of corneal epithelial healing between the two groups (P= 1.00). There was no significant difference between the two groups in the number of eyes distribute with decreased visual acuity (2 eyes in each group), stable visual acuity (15 eyes in the experimental group and 23 eyes in the control group), and improved visual acuity (13 eyes in the experimental group and 5 eyes in the control group) (P=0.053). There was no recurrence in the two groups at 12 months after surgery, and there was no significant difference between the two groups in the number of patients with conjunctival hyperplasia of grades 1, 2 and 3 (P=0.405). Conclusions: Modified conjunctival transplantation and amniotic membrane transplantation combined with use of IFN alpha-2b eye drops got low recurrence rate for primary pterygium and less damage to the healthy conjunctival tissue. This combined treatment strategy provides a new choice for the treatment of pterygium. (Chin J Ophthalmol, 2020, 56: 768-773).

Evaluation of change in pterygium induced keratometric astigmatism in patients following pterygium excision with autologous graft surgery.

In this study total 64 eyes of 64 patients were enrolled having the diagnosis of pterygium. Prior to the pterygium excision surgery all the enrolled patients were studied for grading of pterygium, clinical symptoms, keratometric values and best corrected visual acuity (BCVA). Postoperatively, BCVA and keratometric readings were recorded at one week, one month, two months and four months intervals. Mean age of study participants was 34.16 ± 8.24 years in the age group of 18-60 years. 42 (65.62%) eyes had grade II pterygium, while 16 (25.0 %) and 6 (9.38%) eyes were having grade III and grade IV pterygium, respectively. Preoperative median and quartiles (25% -75%) horizontal and vertical keratometric values were 43.00 (42.50-44.00) D and 44.25 (43.75-44.50) D, respectively and both reduced significantly to 42.50 (42.50-42.94) D and 42.50 (42.50- 43.00) D, respectively after four months postoperatively. Median keratometric astigmatism before surgery was 1.37 (1.25-1.93) D which reduced significantly to 0.50 (0.32-0.75) D after four months of pterygium excision. Similarly, BCVA improved significantly [0.20(0.16-0.25) vs 0.53 (0.50-0.80)] when assessed postoperatively after four months. Excision of pterygium with autologous graft reduced pterygium-induced keratometric astigmatism and improved BCVA significantly.

Corneal Topographic Changes After Two Different Grafting Pterygium Surgery Techniques

Background: Surgical treatment of pterygium can result in corneal topographic changes. It is not clear that those changes are universal or technique dependent. Objectives: Evaluation of corneal topographic changes following pterygium surgery using sutured conjunctival autografting versus sutured amniotic membrane grafting. Patients and methods: In this prospective randomized study, patients suffering from primary pterygia that extend between two and four millimeters over the cornea were included. Patients were separated into group I; underwent pterygium excision with sutured conjunctival autograft, and group II underwent pterygium excision with sutured amniotic membrane graft after a comprehensive ophthalmic examination. The following topographic parameters were noted: the axial curvature map, elevation posterior map, and corneal thickness map. Results: Significant improvement of the mean visual acuity measured using the logMAR test was found in both groups postoperatively. The improvement included UCVA and BCVA as well as anterior keratmetric and cylindrical power of the cornea without significant dissimilarity between study groups. No statistically considerable changes in the posterior corneal surface or the corneal thickness were found. Conclusions: Pterygium excision can cause changes in the keratmetric and cylindrical power of the cornea without the affection of the posterior corneal surface or the corneal thickness. The corneal topographic changes caused by the pterygium were not varied with the type of surgical technique used.

Corneal Topographic Changes After Two Different Grafting Pterygium Surgery Techniques

Background: Surgical treatment of pterygium can result in corneal topographic changes. It is not clear that those changes are universal or technique dependent. Objectives: Evaluation of corneal topographic changes following pterygium surgery using sutured conjunctival autografting versus sutured amniotic membrane grafting. Patients and methods: In this prospective randomized study, patients suffering from primary pterygia that extend between two and four millimeters over the cornea were included. Patients were separated into group I; underwent pterygium excision with sutured conjunctival autograft, and group II underwent pterygium excision with sutured amniotic membrane graft after a comprehensive ophthalmic examination. The following topographic parameters were noted: the axial curvature map, elevation posterior map, and corneal thickness map. Results: Significant improvement of the mean visual acuity measured using the logMAR test was found in both groups postoperatively. The improvement included UCVA and BCVA as well as anterior keratmetric and cylindrical power of the cornea without significant dissimilarity between study groups. No statistically considerable changes in the posterior corneal surface or the corneal thickness were found. Conclusions: Pterygium excision can cause changes in the keratmetric and cylindrical power of the cornea without the affection of the posterior corneal surface or the corneal thickness. The corneal topographic changes caused by the pterygium were not varied with the type of surgical technique used.

Surgical treatment of pterygium in melanoderma: Preliminary results of the conjunctival autograft at the infirmary of bamako hospital

Pterygium is a benign eye disease with varying prevalence in different regions. Ultraviolet light is the main risk factor. The curative treatment is surgical, but it remains incompletely effective with recurrences that are not rare. Many techniques are described alone or combined with adjuvant treatments. The aim of our work is to evaluate the preliminary outcome of pterygial excision with conjunctival autograft.A prospective study was carried out between May 2016 and October 2017 in the ophthalmology department of the Bamako Hospital Infirmary. It included 81 patients who had a primary or recurrent pterygium operated on in the department.The average age was 45.74 years. The sex ratio was 1.13 M/F. Of the 81 pterygions operated on, 14.8% were stage IV and 16% recurrent, with nasal localization in 92.6%. Conjunctival hyperhaemia more or less associated with subconjunctival haemorrhage was present until postoperative day 15. We noted 4.9% recurrence.There is no consensus in the surgical treatment of pterygions. The technique of removal of the pterygium associated with conjunctival autograft would induce fewer complications and the least recurrence.Early management of pterygium with the autograft technique remains the best therapeutic choice for this condition.

Inhibitory Effect of Valsartan on Pterygium Fibroblasts.

Angiotensin receptor blockers (ARBs) were shown to have antifibrotic properties in ocular and systemic diseases. In this study, our aim was to investigate the effect of an angiotensin receptor blocker, valsartan, on pterygium fibroblasts and compare this effect with that of mitomycin C (MMC). Pterygium tissue samples were obtained from 3 patients during surgical excision. Primary cultured pterygium fibroblasts and L929 cell cultures were treated with different concentrations of MMC and valsartan. The cell viability decreased with increasing concentrations of valsartan at 48 hours for both cell types. MMC inhibited the proliferation of both cell types at 48 hours. Both agents significantly decreased the cell migration of the 2 cell types, although it was more prominent in the MMC-treated group. Valsartan inhibited the proliferation and migration of pterygium fibroblasts. The known favorable safety profile of these drugs and the results of this study showing inhibitory effect on pterygium fibroblasts make valsartan a potential therapeutic agent for pterygium treatment.

A Comparative Study Between Transplantation of Conjunctival Limbal Autograft with Mitomycin C and Amniotic Membrane Transplantation with Mitomycin C in Recurrent Pterygium

Introduction : Pterygium, a wing‐shaped encroachment of the cornea by the conjunctiva, Conjunctival limbal autograft with stem cell (CLAU) or amniotic membrane transplantation (AMT) has been widely adopted in the management of pterygium.Purpose: To compare the efficacy and the complications of conjunctival limbal autograft (CLAU) with mitomycin C 0.2 % and amniotic membrane transplantation (AMT) with mitomycin C 0.2 % for treatment of recurrent pterygiumSubject and methods:80 eyes of 60 patients clinically diagnosed with recurrent pterygium were divided into two groups , group A included 40 eyes underwent pterygium excision and MMC 0.2% with CLAU , group B included 40 eyes underwent pterygium excision and MMC 0.2% with AMT . Recurrence was defined as fibrovascular tissue extension of more than one mm onto the cornea in the area of previously excised pterygium. Mean follow up period 8±1 month . Recurrence was compared in each group by using ӽ2 testResults:No major postoperative complications occurred during 6-9 months of follow-up . In CLAU group (A)only 5 eyes of recurrence occur(12.5%)after 7 months of follow up . Recurrence occur in 12 eyes (30%)in AMT group (B) after 6 months ( P value =0.043, ӽ2 test).The operated site was look like the normal adjacent site in 77%of the non recurrence group A versus 10% in group BConclusion: CLAU with MMC is more effective than AMT with MMC for treatment of recurrent pterygium and the final cosmetic appearance is more acceptable in CLAU group than AMT group B .

К вопросу о возможностях хирургического лечения рецидивирующего птеригиума

К вопросу о возможностях хирургического лечения рецидивирующего птеригиума

Outcomes of Ipsilateral Simple Limbal Epithelial Transplantation, Tenonectomy, Mitomycin and Amniotic Membrane Transplantation for Treatment of Recurrent Pterygium.

To report on the outcomes of recurrent pterygium treated by ipsilateral simple limbal epithelial transplantation (SLET), mitomycin, tenonectomy, and amniotic membrane transplantation. A retrospective, interventional study was conducted including all patients with recurrent pterygium who underwent SLET surgery under a single surgeon using ipsilateral donor tissue with a minimum 6-month follow-up at Toronto Western Hospital, Canada. Outcome measures included the following: recurrence rates, best spectacle-corrected visual acuity, and postoperative complications. Ten eyes of 10 patients, aged 60.7 ± 18.5 years (range 23-79) with a mean follow-up time of 15.2 ± 10.0 months of which 50% (n = 5) were men, were included. Eight eyes (80%) had a history of 2 or less pterygium operations. Two patients had 3 and 5 previous pterygium operations, respectively. Concurrent limbal stem cell disease was noted in 6 eyes (60%). Average number of pterygium recurrences per eye was 1.9 ± 1.3 (range 1-5). Mean pre-op best-corrected visual acuity was 0.5 LogMAR (Snellen equivalent 20/60, range 20/20 to counting fingers). Best-corrected visual acuity remained the same or improved in 6 eyes (60%). Recurrence was noted in 1 eye (10%) with a history of 5 previous pterygium excisions and remained stable at the last follow-up. No patients required a second operation. Ipsilateral SLET with mitomycin, tenonectomy, and amniotic membrane transplantation is a novel technique to address recurrent pterygium. Concurrent limbal stem cell diseases are often present. Initial results demonstrate low recurrence. Visual improvement is modest. Stabilization of the ocular surface to improve vision is possible.

Innovative approach to barrier amnioplasty in surgical treatment of primary progressive pterygium

The aim is to evaluate the efficacy of new method of barrier amnioplasty in surgical treatment of primary progressive pterygium.
 Materials and methods. 40 patients (40 eyes) with primary progressive pterygium, divided into two groups depending on surgical features of barrier amnionoplasty: in the main group (20 patients), plastic surgery was carried out in the semilunar fold area; in the control group (20 patients) in the limbal area. All patients underwent special examination: tear pH measurement and cytological evaluation of the cellular composition from the wound surface. The treatment efficacy was evaluated: in the early postoperative period by the timing of conjunctival inflammation disappearance, corneal epithelialization and vitalization of the amnion; after 1 year according to the state of the limbus, cornea, visual acuity, degree of corneal astigmatism.
 Results and conclusions. The use of amnioplasty method in the area of semilunar fold developed and implemented by us in clinical practice showed high efficacy: time reduction in local cellular inflammatory reactions in the cytological composition of swabs and scrapings and postoperative inflammation of ocular surface, which led to shortening of periods of corneal epithelization by 1.7 times and vitalization of the amnion by 1.5 times. Uncomplicated postoperative course of inflammatory-regenerative reactions allows avoiding the pterygium recurrence and causes reduction of the degree of corneal astigmatism and visual acuity increase.

Comparison between limbal stem cell versus dry amniotic membrane transplantation in treatment of primary pterygium

Abstract Background Pterygium is a degenerative disorder of the conjunctiva which leads to encroachment of bulbar conjunctiva onto the cornea. This invasion causes irritation of ocular surface, irregular astigmatism and loss of visual acuity.surgical treatment of pterygium is directrd towards excision, prevention of recurrence and restoration of ocular surface integrity. A myriad of techniques have been described for achieving these goals. Tha main complication of these procedures is the recurrence rate, which has been estimated as high as 30%_70%. Purpose to compare the efficiency of limbal stem cell transplantation versus dry amniotic membrane transplantation in treatment of pterygium. Patients and Methods The study carried out at ophthalmology department, Ain shams university and included 20 eyes which were classified into two groups; first group included 10 eyes of patients underwent pterygium excision with amniotic membrane transplantation. Second group included 10 eyes of patients underwent pterygium excision with limbal stem cell transplantation. Results the mean follow up duration was 1-3 months in both groups. On comparing recurrence rate between the studied groups which occurred only in the first group in two eyes 20%, there is no statistically significant difference found between the studied groups as regard recurrence. But it was statistically significant better with limbal conjunctival autografting. Graft rejection was not detected in the two groups during follow up period. There was no statistically significant difference found between the studied groups as regard clinical stability and graft rejection. Conclusion Limbal stem cell transplantation proved to be better than amniotic membrane transplantation in treatment of pterygium. As it is more effective in prevention of pterygium reccurence as well as it is of lower cost and better availability than amniotic membrane.

Lamellar keratoplasty in the management of recurrent pterygium

As it is known, the main problem of surgical treatment of pterygium is associated with high risk of recurrence. Quite a number of surgical techniques now exist, all aimed at pterygium removal and only differing in the method of conjunctival closure following the excision. Due to relatively low recurrence rates, conjunctival or conjunctival-limbal autografts are currently the 'gold standard' of pterygium surgery. The frequency of recurrence is also insignificant in peripheral anterior lamellar keratoplasty, which is rarely performed due to its complexity and the need for donor cornea. However, it is considered to be the method of choice in cases of repeated recurrence as well as in patients with high pterygium activity. This article describes a clinical case of a massive recurrent pterygium (grade IV, activity level 3). The patient has had three previous surgeries (including conjunctival autotransplantation) that yielded no success. By performing large-diameter peripheral anterior lamellar keratoplasty in combination with adjuvant therapy (intraoperative mitomycin C and subconjunctival postoperative aflibercept injections), structural integrity of the cornea was finally restored without further recurrences and visual acuity was increased.

Antiangiogenic therapy in the surgical treatment of pterygium

To evaluate the effectiveness and safety of adjuvant anti-VEGF therapy in the surgical treatment of pterygium, and to determine the indications for its use. The study included 67 patients (69 eyes) with grade II-IV pterygium. Patients age was 58.8±12.6 years on average. Best corrected visual acuity (BCVA) varied between 0.01 and 1.0 (0.77±0.24). The patients were divided into 3 groups. The first group included 19 patients (19 eyes) with grade II-III pterygium who underwent «bare sclera» surgery and used aflibercept as adjuvant therapy. The second group included 21 patients (21 eyes) with grade II-IV pterygium who underwent auto conjunctival grafting surgery with no adjuvant therapy. The third group included 27 patients (29 eyes) with grade II-IV pterygium who had it removed in combination with single-time peripheral lamellar keratoplasty (PLK) and underwent adjuvant aflibercept therapy. Among patients who underwent pterygium excision with adjuvant antiangiogenic therapy there were 5 cases (26%) of relapse during the observation period (23.38±8.96 months), among patients after pterygium excision with auto conjunctival plastic surgery - also 5 cases (24%) of relapse, and among patients who underwent LKP combined with anti-VEGF therapy there was only 1 case (3%) of relapse. Astigmatism has decreased by 0.24±0.5 (p=0.052) in the first group, by 1.21±1.0 (p<0.05) in the second group, and by 1.64±1.54 (p<0.05) in the third group compared with pre-surgical values, thus increasing average BCVA in all 3 patient groups by 0.1±0.13, 0.07±0.11 and 0.15±0.15, respectively. The use of anti-VEGF agents as adjuvant therapy in the surgical treatment of pterygium is a safe method of reducing postoperative inflammation, fibrovascular proliferation and, subsequently, the amount of relapses.

Low-Dose Mitomycin C Decreases the Postoperative Recurrence Rate of Pterygium by Perturbing NLRP3 Inflammatory Signalling Pathway and Suppressing the Expression of Inflammatory Factors.

A pterygium is generally believed to be a chronic inflammatory lesion caused by external stimuli that develops from the conjunctiva and grows onto the cornea. Simple bare sclera excision is the most commonly used method to treat pterygium. However, the high postoperative recurrence rate of pterygium remains a persistent challenge. Mitomycin C (MMC) is an antineoplastic antibiotic that inhibits DNA, RNA, and protein synthesis. In recent years, although MMC has proven useful for the treatment of pterygium, its application has been controversial because of its clear toxicity and the possibility of ocular complications. In the current study, we prospectively recruited patients to receive or not receive a local injection of MMC (0.4 mg/ml). Follow-up was conducted with the patients to determine the postoperative recurrence rate of pterygium and/or to observe any ocular complications. The remarkable results demonstrated that MMC can decrease the postoperative recurrence rate of pterygium without leading to serious eye complications. Further results indicated that MMC can inhibit the activation of the NLRP3 inflammatory signalling pathway and thus downregulate the expression of downstream molecules, including IL-18 and IL-1β. MMC also reduced the expression of inflammatory factors TGF-β1, VEGF, and IL-6. In addition to influencing these factors, MMC suppressed neovascularization and the proliferation of corneal fibroblasts to effectively reduce the recurrence rate of pterygium. Taken together, our results provide a theoretical basis for the development of prevention and treatment strategies for pterygium and suggest that MMC is highly effective as an adjunctive treatment after excision of primary pterygia.

Posttranscriptional regulation of MMP-9 by HuR contributes to IL-1β-induced pterygium fibroblast migration and invasion.

Inflammation is considered to be critical in the pterygium progression and recurrence. However, the underlying molecular mechanism is not well understood. Herein, we investigated the potential role of RNA binding protein human antigen R (HuR) responsible for the impact of inflammation on pterygium development. The expression of HuR and matrix metallopeptidase-9 (MMP-9) in pterygium and normal conjunctiva was detected with immunohistochemistry and quantitative reverse transcription polymerase chain reaction (qRT-PCR). The influence of interleukin-1β (IL-1β) on HuR expression and cellular distribution was determined with western blot and immunofluorescence. The pterygium fibroblast (PTF) migration was determined with scratch wound healing assay and Transwell migration assay. MMP-9 production was determined with qRT-PCR and gelatin zymography. The interaction between HuR and MMP-9 was investigated with RNP immunoprecipitation (IP) followed by RT-PCR and messenger RNA (mRNA) stability analysis. HuR and MMP-9 expression are elevated in pterygium, especially progressive pterygium compared with normal conjunctiva. IL-1β could increase the expression and nucleus-cytoplasm shuttle of HuR in cultured PTFs. HuR mediated the stimulatory effect of IL-1β on PTF migration and MMP-9 production. HuR bound to MMP-9 mRNA and in turn increased it stability. Our results suggest that posttranscriptional regulation of MMP-9 via stabilizing mRNA by HuR might contribute to the stimulatory effect of inflammatory factor IL-1β on pterygium progression. These findings shed light on the pathogenesis of pterygium and provide a promising target for adjuvant treatment of pterygium.

A Retrospective Study to Compare the Recurrence Rate After Treatment of Pterygium by Conjunctival Autograft, Primary Closure, and Amniotic Membrane Transplantation.

BackgroundThis study aimed to investigate the effectiveness of conjunctival autograft compared with primary closure and amniotic membrane transplantation for primary pterygium excision.Material/MethodsData were retrospectively studied from all primary pterygium excisions from January 2002 to December 2017 from the electronic database at the University Eye Hospital, Tübingen.ResultsFrom 521 primary pterygium excisions, 284 (54.5%) were primary closures, 203 (39.0%) were conjunctival autografts, and 34 (6.5%) were amniotic membrane transplants. The mean number of primary pterygium excisions was 33 per year (range, 14–56 per year). The mean patient age was 58±15 years. Younger age was associated with a significantly increased recurrence rate (P=0.002). The mean pterygium recurrence rate in the three study groups at 12 months after surgery was 11.3% (range, 6.4–14.7%). Recurrence occurred 13 patients (6.4%) in the conjunctival autograft group, 41 patients (14.4%) in the primary closure group, and five patients (14.7%) in the amniotic membrane transplantation group. Conjunctival autograft was associated with a significantly lower recurrence rate (P=0.005).ConclusionsA retrospective study at a single center to compare conjunctival autograft with primary closure and amniotic membrane transplantation for primary pterygium excision showed a significantly lower recurrence rate after surgery using a conjunctival autograft.

Effect of multiple subconjunctival conbercept injections as an adjuvant to the surgical treatment of pterygium: a prospective randomised comparative 6-month follow-up study.

To evaluate the safety and efficacy of multiple subconjunctival injections of conbercept for pterygium patients after surgery. As a prospective randomised interventional trial, 96 eyes from 96 patients with a tendency to recur were collected and divided randomly into conbercept and 5-fluorouracil groups on the 5th day after pterygium. All patients received three subconjunctival injections of conbercept (0.2 ml) or 5-fluorouracil (0.2 ml) on the 5th day (baseline), and 2 and 4 weeks post-operatively. The pterygium morphology, colour intensity, recurrence, and complications were recorded and analysed pre-1st injection and 1 day, 1 week, 1 month, 3 months, and 6 months post-3rd injection. Moreover, no patient was drop-out. There were striking differences between the two groups on post-3rd injections 1 day, 1 week, 1 month, 3 months, and 6 months (p = 0.001, 0.002, 0.000, 0.000, and 0.002, respectively) with respect to colour intensity: the eyes in conbercept group were lighter than the 5-Fu group. On post-3rd injection 6 months, prominent disparities existed between the two groups with respect to pterygium morphology (p = 0.006) and recurrence (p = 0.002), occurred in the conbercept group prior to the 5-Fu group. Moreover, corneal abrasions were not noted in the conbercept group, which was significantly less than the 5-Fu group (17/48; p = 0.000). There was no conspicuous discrepancy between the two groups with respect to subconjunctival haemorrhage (p = 0.789) and persistent epithelial defects (p = 0.078). Multiple subconjunctival conbercept injections as an adjunct therapy for pterygium surgery was shown to be safe, effective, and well-tolerated.

Ошибки в лечении птеригиума

Ошибки в лечении птеригиума

Targeting platelet-derived growth factor receptor β inhibits the proliferation and motility of human pterygial fibroblasts

ABSTRACTBackground: Pterygium, a common eye disease with high postoperative recurrence, lacks effective therapeutic strategies. Therefore, it’s urgent to identify specific targets to develop rationally targeted molecular drugs for the pterygial therapy.Methods: The cell proliferation and motility were studied in both the primary human pterygial fibroblasts (hPFs) and an ex vivo pterygium model. hPFs transfected with the pCMV3-PDGFRB plasmid, PDGFRB siRNA and CRISPR/Cas9 system were used to determine the role of PDGFR-β in pterygial fibroblasts functions. Western blotting, immunohistochemistry and immunofluorescence were performed to evaluate the expression of the key proteins.Results: PDGFR-β expression in the pterygial stroma and primary hPFs was significantly higher than that in the conjunctiva and human conjunctival fibroblasts. PDGF-BB promoted the proliferation, migration and invasion of hPFs, which can be significantly suppressed by sunitinib via inhibition of the PDGFR-β/extracellular signal-regulated kinase (ERK) pathway. In the ex vivo model, the knockout of PDGFRB and sunitinib treatment blocked the proliferation and motility of fibroblasts in the pterygial stroma via the suppression of PDGFR-β/ERK pathway.Conclusion: This study demonstrates that PDGFR-β may be a potential therapeutic target for pterygium, and inhibition of PDGFR-β by sunitinib is a promising and effective approach for pterygium treatment.

Practice Patterns in the Management of Primary Pterygium: A Survey Study.

To characterize cornea specialists' current practice preferences in the management of primary pterygium. A 25-item survey regarding indications for surgery, surgical technique, use of adjuvant therapy, type and duration of postoperative therapy, and treatment of early recurrences was designed and sent to members of the Cornea Society through the kera-net listserv. In total, 199 cornea specialists completed the questionnaire. More than 90% considered that surgery should be performed when there is proximity of the pterygium to the visual axis, pain or redness, eye movement restriction, or induction of astigmatism. Cosmesis was considered as an indication by 41.7% of the participants. The most frequent technique for pterygium excision was complete resection including the base and a moderate quantity of Tenon capsule followed by autologous conjunctival or limbal-conjunctival graft. The preferred graft fixation method in this survey was fibrin glue (61.2%). Most respondents reported a recurrence rate of less than 5% and no use of adjuvant agents to prevent recurrence. When early recurrence did occur, the preferred agents were corticosteroids. This study reflects the preferences of cornea experts regarding primary pterygium treatment and may serve as a guide for the management of this pathology.